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Dave Jones

It took a voter revolt 29 years ago to force the insurance industry to start pricing auto insurance in California based on how well and how much you drive, instead of who you are or where you live. Before that, drivers in inner cities and other “undesirable” zip codes (read: low-income, minority) had to pay a fortune for auto insurance, if they could buy it at all. Prop 103’s insurance reforms changed that. Or at least they were supposed to.

Last week, the California Department of Managed Health Care approved the merger of Aetna and Humana. The move seemed unlikely after a hearing at which DMHC Director Shelley Rouillard expressed skepticism about how the deal could benefit consumers, noting especially Aetna’s history of serial unreasonable rate hikes ($39 million in excessive rates in just 8 months).

In fact, Anthem and Cigna’s executives could not provide any concrete examples of how the Anthem-Cigna merger would benefit consumers at the four-hour hearing into the merger I attended at the Department of Insurance.

Inadequate physician networks and out-of-network billing have cast an ugly shadow over the expanding healthcare market as more people have access to healthcare. Next Monday, the Department of Insurance will hold a hearing on new proposed regulations covering network adequacy and out-of-network billing in emergency services.